To the Editor: The meta-analysis by Dr Barone and colleagues1 showed that patients diagnosed with cancer who have preexisting diabetes are at increased risk for all-cause mortality compared with those without diabetes. We agree with this conclusion but have 2 comments. First, the study by Kouvaris et al2 included only 30 cancer patients with diabetes and 50 patients in total. Therefore, we wonder whether in Figure 2 the random-effects weight and the large data marker are correct.
Second, the authors discussed the possibility that patients with preexisting diabetes may present with later-stage disease. In our study of 5555 newly diagnosed cancer patients with diabetes, we found that they presented more often with later-stage colon, breast, or ovarian cancer than patients without diabetes.3 Adjustment for stage and treatment decreased the hazard ratio (HR) for overall mortality for women with ovarian cancer from 1.50 (95% confidence interval [CI], 1.16-1.93) to 1.31 (95% CI, 1.02-1.70). However, for breast, colon, and other cancers, differences in stage or treatment did not change the observed hazard ratios significantly.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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